Cargando…
Cost-Effectiveness of a School-Based Social and Emotional Learning Intervention: Evidence from a Cluster-Randomised Controlled Trial of the Promoting Alternative Thinking Strategies Curriculum
BACKGROUND: School-based social and emotional learning interventions can improve wellbeing and educational attainment in childhood. However, there is no evidence on their effects on health-related quality of life (HRQoL) or on their cost effectiveness. OBJECTIVE: Our objective was to evaluate the co...
Autores principales: | , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer International Publishing
2019
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7085485/ https://www.ncbi.nlm.nih.gov/pubmed/31347016 http://dx.doi.org/10.1007/s40258-019-00498-z |
_version_ | 1783508944632676352 |
---|---|
author | Turner, Alex J. Sutton, Matt Harrison, Mark Hennessey, Alexandra Humphrey, Neil |
author_facet | Turner, Alex J. Sutton, Matt Harrison, Mark Hennessey, Alexandra Humphrey, Neil |
author_sort | Turner, Alex J. |
collection | PubMed |
description | BACKGROUND: School-based social and emotional learning interventions can improve wellbeing and educational attainment in childhood. However, there is no evidence on their effects on health-related quality of life (HRQoL) or on their cost effectiveness. OBJECTIVE: Our objective was to evaluate the cost effectiveness of the Promoting Alternative Thinking Strategies (PATHS) curriculum. METHODS: A prospective economic evaluation was conducted alongside a cluster-randomised controlled trial of the PATHS curriculum implemented in the Greater Manchester area of England. In total, 23 schools (n = 2676 children) were randomised to receive PATHS, and 22 schools (n = 2542 children) were randomised to continue with usual practice. A UK health service perspective and a 2-year time horizon were used. HRQoL data were collected prospectively from all children in the trial via the Child Health Utility Nine-Dimension questionnaire. Micro-costing was undertaken to estimate the intervention costs. Missing data were imputed using multiple imputation. RESULTS: The mean incremental cost of the PATHS curriculum compared with usual practice was £32.01 per child, and mean incremental quality-adjusted life-years (QALYs) were positive (0.0019; 95% confidence interval [CI] 0.0009–0.0029). Assuming a willingness-to-pay threshold of £20,000 per QALY, the expected incremental net benefit of introducing the PATHS curriculum was £5.56 per child (95% CI − 14.68 to 25.81), and the probability of cost effectiveness was 84%. However, this probability fell to 0% when intervention costs included teacher’s salary costs. CONCLUSION: The PATHS curriculum has the potential to be cost effective at standard UK willingness-to-pay thresholds. However, the sensitivity of the cost-effectiveness estimates to key assumptions means decision makers should seek further information before allocating scarce public resources. TRIAL REGISTRATION NUMBER: ISRCTN85087674. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s40258-019-00498-z) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-7085485 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Springer International Publishing |
record_format | MEDLINE/PubMed |
spelling | pubmed-70854852020-03-23 Cost-Effectiveness of a School-Based Social and Emotional Learning Intervention: Evidence from a Cluster-Randomised Controlled Trial of the Promoting Alternative Thinking Strategies Curriculum Turner, Alex J. Sutton, Matt Harrison, Mark Hennessey, Alexandra Humphrey, Neil Appl Health Econ Health Policy Original Research Article BACKGROUND: School-based social and emotional learning interventions can improve wellbeing and educational attainment in childhood. However, there is no evidence on their effects on health-related quality of life (HRQoL) or on their cost effectiveness. OBJECTIVE: Our objective was to evaluate the cost effectiveness of the Promoting Alternative Thinking Strategies (PATHS) curriculum. METHODS: A prospective economic evaluation was conducted alongside a cluster-randomised controlled trial of the PATHS curriculum implemented in the Greater Manchester area of England. In total, 23 schools (n = 2676 children) were randomised to receive PATHS, and 22 schools (n = 2542 children) were randomised to continue with usual practice. A UK health service perspective and a 2-year time horizon were used. HRQoL data were collected prospectively from all children in the trial via the Child Health Utility Nine-Dimension questionnaire. Micro-costing was undertaken to estimate the intervention costs. Missing data were imputed using multiple imputation. RESULTS: The mean incremental cost of the PATHS curriculum compared with usual practice was £32.01 per child, and mean incremental quality-adjusted life-years (QALYs) were positive (0.0019; 95% confidence interval [CI] 0.0009–0.0029). Assuming a willingness-to-pay threshold of £20,000 per QALY, the expected incremental net benefit of introducing the PATHS curriculum was £5.56 per child (95% CI − 14.68 to 25.81), and the probability of cost effectiveness was 84%. However, this probability fell to 0% when intervention costs included teacher’s salary costs. CONCLUSION: The PATHS curriculum has the potential to be cost effective at standard UK willingness-to-pay thresholds. However, the sensitivity of the cost-effectiveness estimates to key assumptions means decision makers should seek further information before allocating scarce public resources. TRIAL REGISTRATION NUMBER: ISRCTN85087674. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s40258-019-00498-z) contains supplementary material, which is available to authorized users. Springer International Publishing 2019-07-26 2020 /pmc/articles/PMC7085485/ /pubmed/31347016 http://dx.doi.org/10.1007/s40258-019-00498-z Text en © The Author(s) 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/), which permits any noncommercial use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. |
spellingShingle | Original Research Article Turner, Alex J. Sutton, Matt Harrison, Mark Hennessey, Alexandra Humphrey, Neil Cost-Effectiveness of a School-Based Social and Emotional Learning Intervention: Evidence from a Cluster-Randomised Controlled Trial of the Promoting Alternative Thinking Strategies Curriculum |
title | Cost-Effectiveness of a School-Based Social and Emotional Learning Intervention: Evidence from a Cluster-Randomised Controlled Trial of the Promoting Alternative Thinking Strategies Curriculum |
title_full | Cost-Effectiveness of a School-Based Social and Emotional Learning Intervention: Evidence from a Cluster-Randomised Controlled Trial of the Promoting Alternative Thinking Strategies Curriculum |
title_fullStr | Cost-Effectiveness of a School-Based Social and Emotional Learning Intervention: Evidence from a Cluster-Randomised Controlled Trial of the Promoting Alternative Thinking Strategies Curriculum |
title_full_unstemmed | Cost-Effectiveness of a School-Based Social and Emotional Learning Intervention: Evidence from a Cluster-Randomised Controlled Trial of the Promoting Alternative Thinking Strategies Curriculum |
title_short | Cost-Effectiveness of a School-Based Social and Emotional Learning Intervention: Evidence from a Cluster-Randomised Controlled Trial of the Promoting Alternative Thinking Strategies Curriculum |
title_sort | cost-effectiveness of a school-based social and emotional learning intervention: evidence from a cluster-randomised controlled trial of the promoting alternative thinking strategies curriculum |
topic | Original Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7085485/ https://www.ncbi.nlm.nih.gov/pubmed/31347016 http://dx.doi.org/10.1007/s40258-019-00498-z |
work_keys_str_mv | AT turneralexj costeffectivenessofaschoolbasedsocialandemotionallearninginterventionevidencefromaclusterrandomisedcontrolledtrialofthepromotingalternativethinkingstrategiescurriculum AT suttonmatt costeffectivenessofaschoolbasedsocialandemotionallearninginterventionevidencefromaclusterrandomisedcontrolledtrialofthepromotingalternativethinkingstrategiescurriculum AT harrisonmark costeffectivenessofaschoolbasedsocialandemotionallearninginterventionevidencefromaclusterrandomisedcontrolledtrialofthepromotingalternativethinkingstrategiescurriculum AT hennesseyalexandra costeffectivenessofaschoolbasedsocialandemotionallearninginterventionevidencefromaclusterrandomisedcontrolledtrialofthepromotingalternativethinkingstrategiescurriculum AT humphreyneil costeffectivenessofaschoolbasedsocialandemotionallearninginterventionevidencefromaclusterrandomisedcontrolledtrialofthepromotingalternativethinkingstrategiescurriculum |